ORDER FORM -- Cruiser’s CrutchTM


~ WE ACCEPT MAIL ORDERS ONLY ~
        Right Click on form to print it, complete form and MAIL TO:

SEC, Inc. - Cruiser's Crutch
825 Cove Parkway, Suite A
Cottonwood, AZ 86326


Click HERE to return to Cruisers's Crutch Page

ORDERING INFORMATION
Name:
Company:
Title:
Address:
City:
State:
Country:
Zip/Country Code:
Phone (only in case of problems):
Email (optional):

Available in English or Metric models: English (E) BAF's: 10, 20, 30 & 40.....$33.29 Metric (M) BAF's: 2, 3, 4, 5 & 6..........$33.29
(E)/(M)	Quantity	Unit Price	Amount
English (E)	x	$33.29           =
Metric (M)	x	$33.29           =
	x	=
Arizona Sales Tax (x%):
Shipping & Handling Charges (0 for Orders Over $50.00):			$5.00
Priority Overnight - (Add $16.00):
TOTAL:

Cashier's Check or Money Orders Only

Payable to "SEC-Cruiser's Crutch"

Mail order and payment to:

SEC, Inc-Cruiser's Crutch
825 Cove Parkway, Suite A
Cottonwood, AZ 86326

Please do not send cash
Allow 5-10 working days for normal delivery.